How safe and effective is stentless laparoscopic ureterolithotomy in elderly patients?

Abstract

Purpose: With the improvement of minimally invasive urology procedures, open surgical interventions are less common to treat ureteral calculus. Laparoscopic ureterolithotomy (LU) indications are large multiple and/or impacted ureteral calculus that may not be treated with shock-wave lithotripsy or ureterorenoscopy approaches.The aim of our study was to investigate the feasibility and safety of stentless LU in elderly patients.Methods: Between October 2011 and December 2019, 38 geriatric patients underwent stentless transperitoneal LU for upper/mid ureteral calculi. The transperitoneal route was applied in all patients by two surgeons. No double J stent inserted in any patient. The data of all patients reviewed retrospectively. Results:The average age was 64.60 ± 3.70 years. The mean calculi size was 19.42 ± 1.41 mm. Ten patients had unsuccessful shock wave lithotripsy or ureterorenoscopy history. The calculi-free rate was 100%. Clavien grade 1 complications were seen in 11 (28.9%) cases. No major perioperative and postoperative complications were encountered. The average length of hospital stay was 3.24 ± 1.53 days. Conclusion:The significant advances in medical technology and healthcare, lead a rising number of geriatric patients to take benefit of even complicated surgery.Although laparoscopy and its safety in the geriatric population pursues a challenge and the assessment of this procedure is hence obligatory, we think that stentless LU is safe, economical and less uncomfortable for elderly patients.How to cite this article: Aydin C, Akkoc A, Aydin ZB. How safe and effective is stentless laparoscopic ureterolithotomy in elderly patients?.